Program Manager Sr (Marketplace)

CalOptima

CalOptima Health is seeking a highly motivated an experienced Program Manager Sr (Marketplace) to join our team. The Program Manager Sr plays a vital role in program design, development, implementation and overall support of the implementation for new product lines, including commercial. The incumbent will be responsible for coordination, execution and completion of tasks supporting new program development and implementation. The incumbent will assist in the overall day-to-day activities, cross-functional projects and other assignments in the department, including program development, operations, and project management. The incumbent will interact with CalOptima Health's executives and department management, legal counsel and staff. The incumbent will also support other CalOptima Health staff on related projects.

Position Information

Department: Strategic Development
Salary Grade: 313 - $90,820 - $145,312 ($43.66 - $69.8615)
Work Arrangement: Partial Telework
*This position is eligible for telework in California.**

Duties & Responsibilities

85% - Program Support
Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
Provides overall program leadership, recommendations, guidance, risk management and support of end-to-end operations and interdependencies.
Ensures strategic direction of projects/program is in line with department goals and CalOptima Health's strategic priorities.
Makes moderate to significant improvements of processes, systems or products to enhance performance of job area.
Plans and implements multiple and complex projects/programs spanning across business areas.
Monitors, analyzes and reports on health care marketplace conditions, marketplace requirements and policy developments/changes.
Conducts analysis and assesses information from different sources focused on health care initiatives, new programs or focus areas as assigned.
Partners with CalOptima Health and subject matter experts to review data sources, evaluate new initiatives, develop summary reports, formulate conclusions and make recommendations for leadership consideration.
Tracks and manages concurrent initiatives ensuring all projects meet success parameters and targets.
Develops an initial workplan for assigned projects and assignments, and manages the scope, schedule, budget and quality of the project.
Develops workflows, key performance indicator (KPI) dashboards, procedures and/or policies and recommends changes to ensure timely, efficient and effective outputs.
Develops specifications and/or scopes of work for requests for proposal (RFP), requests for quotes (RFQ) or requests for inquiry (RFI)'s to support new program development.
Drafts presentations, board reports and memos to support senior management.
Creates detailed reports for internal departments, external stakeholders and state agencies.
Supports project workgroup activities.
10% - Administrative Support
Assists, shares knowledge with and mentors CalOptima Health staff regarding standards, organizational understanding and relationship building to promote successful delivery of projects.
Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
Assists management with vendor support and purchasing activities related to strategic programs and pilots for the department.
Supports the day-to-day marketplace team administrative activities.
5% - Other
Completes other projects and duties as assigned.

Minimum Qualifications

Bachelor's degree in public health, business, health care administration or related field PLUS 4 years of experience in health care programs, including cross-collaboration and coordination, and internal and external stakeholder engagement (e.g. member/patient, provider, community, health networks, contractor/vendor etc.) required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Experience at a health plan, health system, health provider, public agency or hospital setting required.

Preferred Qualifications

Master's degree.
Experience in project/program management.
Managed care operations experience.
2 years of experience and aptitude for working in a highly matrixed, mission-driven organization.

Required Licensure / Certifications

n/a

Knowledge & Abilities

Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
Work independently and exercise sound judgment.
Communicate clearly and concisely, both orally and in writing.
Work a flexible schedule; available to participate in evening and weekend events.
Organize, be analytical, problem-solve and possess project management skills.
Work in a fast-paced environment and in an efficient manner.
Manage multiple projects and identify opportunities for internal and external collaboration.
Motivate and lead multi-program teams and external committees/coalitions.
Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

Ability to visually read information from computer screens, forms and other printed materials and information.
Ability to speak (enunciate) clearly in conversation and general communication.
Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Work Environment

If located at the 500, 505 Building or a remote work location:

Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
There are no harmful environmental conditions present for this job.
The noise level in this work environment is usually moderate.

If located at PACE

Work is typically indoors in a clinical setting serving the frail and elderly.
There may be harmful or hazardous environmental conditions present for this job.
The noise level in this work environment is usually moderate to loud.

If located in the Community

Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
Employee will occasionally work outdoors in varied temperatures.
There may be harmful or hazardous environmental conditions present for this job.
The noise level in this work environment is usually moderate to loud.

About CalOptima Health

CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

About our Benefits & Wellness options

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the 2025 CalOptima Health Benefits Guide regarding our comprehensive benefits and wellness package.

IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is May 21, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet.

Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application.

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

To apply, please visit: https://jobs.caloptima.org/jobs/program-manager-sr-marketplace-505-city-parkway-west-california-united-states

Copyright 2025 Jobelephant.com Inc. All rights reserved.

Posted by the FREE value-added recruitment advertising agency

jeid-48f124e426869745a371dee8f0a95ca0

Qualifications

Bachelor's degree in public health, business, health care administration or related field PLUS 4 years of experience in health care programs, including cross-collaboration and coordination, and internal and external stakeholder engagement (e.g. member/patient, provider, community, health networks, contractor/vendor etc.) required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying
Experience at a health plan, health system, health provider, public agency or hospital setting required
n/a
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds
Work independently and exercise sound judgment
Communicate clearly and concisely, both orally and in writing
Organize, be analytical, problem-solve and possess project management skills
Work in a fast-paced environment and in an efficient manner
Manage multiple projects and identify opportunities for internal and external collaboration
Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment
Ability to visually read information from computer screens, forms and other printed materials and information
Ability to speak (enunciate) clearly in conversation and general communication
Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions
Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting
The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening)

Benefits

Salary Grade: 313 - $90,820 - $145,312 ($43.66 - $69.8615)
Work Arrangement: Partial Telework
At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off
To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities
Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution
For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options

Responsibilities

The Program Manager Sr plays a vital role in program design, development, implementation and overall support of the implementation for new product lines, including commercial
The incumbent will be responsible for coordination, execution and completion of tasks supporting new program development and implementation
The incumbent will assist in the overall day-to-day activities, cross-functional projects and other assignments in the department, including program development, operations, and project management
The incumbent will interact with CalOptima Health's executives and department management, legal counsel and staff
The incumbent will also support other CalOptima Health staff on related projects
85% - Program Support
Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability
Provides overall program leadership, recommendations, guidance, risk management and support of end-to-end operations and interdependencies
Ensures strategic direction of projects/program is in line with department goals and CalOptima Health's strategic priorities
Makes moderate to significant improvements of processes, systems or products to enhance performance of job area
Plans and implements multiple and complex projects/programs spanning across business areas
Monitors, analyzes and reports on health care marketplace conditions, marketplace requirements and policy developments/changes
Conducts analysis and assesses information from different sources focused on health care initiatives, new programs or focus areas as assigned
Partners with CalOptima Health and subject matter experts to review data sources, evaluate new initiatives, develop summary reports, formulate conclusions and make recommendations for leadership consideration
Tracks and manages concurrent initiatives ensuring all projects meet success parameters and targets
Develops an initial workplan for assigned projects and assignments, and manages the scope, schedule, budget and quality of the project
Develops workflows, key performance indicator (KPI) dashboards, procedures and/or policies and recommends changes to ensure timely, efficient and effective outputs
Develops specifications and/or scopes of work for requests for proposal (RFP), requests for quotes (RFQ) or requests for inquiry (RFI)'s to support new program development
Drafts presentations, board reports and memos to support senior management
Creates detailed reports for internal departments, external stakeholders and state agencies
Supports project workgroup activities
10% - Administrative Support
Assists, shares knowledge with and mentors CalOptima Health staff regarding standards, organizational understanding and relationship building to promote successful delivery of projects
Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department
Assists management with vendor support and purchasing activities related to strategic programs and pilots for the department
Supports the day-to-day marketplace team administrative activities
5% - Other
Completes other projects and duties as assigned
Work a flexible schedule; available to participate in evening and weekend events
Motivate and lead multi-program teams and external committees/coalitions
Lifting and moving objects, patients and/or equipment 10 to 25 pounds
Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed
Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed
Employee will occasionally work outdoors in varied temperatures

CalOptima

Job Type